Pre-licensing visit·April 18, 2024

Licensing Program Analysts (LPAs) Rebecca Ruiz and Ryan Fulton conducted an announced Pre-Licensing visit. LPAs were met by Applicant Lady Camille Parker and were granted entry into the facility. The purpose of today's visit is to inspect the facility to ensure that the facility is in compliance with California Code of Regulations, Title 22, Division 6. The fire inspection was completed on 1/18/2024 and the facility is approved for 6 bedridden residents. Facility is approved for 6 hospice residents. During today's visit, LPAs toured the facility and inspected every room. The facility was found to be clean, safe, and in good repair with no pathway obstructions. Resident bathrooms were observed to be clean and the toilets and showers were found to be in working order. There was no grab bar for the toilet in the private bathroom. The facility's water temperature in private bathroom was measured at 111.7 degrees Fahrenheit and common bathroom was measured at 107.0 degrees Fahrenheit. LPAs observed locked storage areas where all hazardous and/or toxic chemicals were stored and secured. LPAs observed locked storage for resident medications. A functioning carbon monoxide detector and smoke detectors were observed in the facility. No bodies of water were observed on the premises. LPAs did not observe enough linens for resident use or chairs in resident rooms. LPAs did not observe emergency lighting or a first aid kit and manual present at the facility. Additionally, hazardous items were accessible in the facility garage and backyard. LPAs observed 7-day supply of non-perishable food. Required postings were observed in a common area of the facility. LPAs reviewed facility’s Infection Control Plan and Emergency Disaster Plan. LPAs did not conduct Component III training during today's visit. Pre-licensing is incomplete and the facility is not ready to be licensed at this time. Applicant will install grab bars, purchase linens and furniture, emergency lighting, first aid kit and manual and will notify LPAs when facility is ready for another inspection. An exit interview was conducted with the applicant, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 3/22).